Surgery Clinics Journal ISSN: 2687-6973

Case Report

Laparoscopic Cholecystectomy on Complete Situs

Inversus: About a Case, how does it Work?
Zatir S*, Medjamea A, Bouazzaoui A, Lounici S, Bouchakor S, Kroumli B, Abdellaoui K and Selmani ZE
Department of General Surgery, University Military Hospital of Oran, Algeria

Abstract
Implementation places the trocars in front of this "mirror organ effect" intra-abdominally. Preoperative diagnosis is facilitated by the additional examinations
cited in our observation.
Keywords: Situs inversus; Laparoscopy; Cholecystectomy

Introduction easy diagnosis by a simple telethorax and an abdominal ultrasound.

The laparoscopic approach of complete cholecystectomy on situs
Laparoscopy has become the gold standard in the treatment of
inversus requires special attention seen "the mirror effect of the
symptomatic gallstones. We had the chance to operate on a patient
organs" intra-abdominally. The placement of the trocars by the French
by laparoscopy for symptomatic gallstones with a complete situs
method facilitated cholecystectomy; for the surgeon, it requires a
inversus discovered preoperatively. This situation made us change
certain dexterity and vigilance gestures for the difficulty and variation
our laparoscopic approach by the introduction of trocarts using the
of the anatomy (Figure 3).
French method which facilitated the cholecystectomy. It has to be
noted that only twenty cases have been published so far [1]. Conclusion
Observation Laparoscopic cholecystectomy on situs inversus is a rare
intervention by its particular approach given the variation of anatomy;
BN patient, 46 years old, with no specific history admitted
however the French position facilitates cholecystectomy on this type
through the consultation for treatment load of symptomatic vesicular
of anatomical variation.
lithiasis. The story of the disease seems to go back several days ago by
the installation bar epigastric pain with vomiting what motivated the
patient to consult. A series additional examination has been carried
out. An abdominal ultrasound objective the presence of a situs
inversus (the spleen is located in the right hypochondrium and the
liver is located in the left hypochondrium with a vesicle gall bearing
many stones, the largest of which measures 8 mm, the main bile duct
free [2-4]. To confirm the diagnosis of complete situs inversus, a
telethorax has been performed which shows dextrocardia (Figure 1).
Telethorax from the front in the left flank, a 5 mm trocar at the
level of the flank right for the gripper (the operating aid is placed on
the patient's left). We realized our cholecystectomy (Figure 2) after
careful release and meticulous of multiple epiploic adhesions; the
intervention took us longer than usual given the situation unusual Figure 1: Dextrocardia.
gallbladder.
Discussion
The complete situs inversus is a rare situation which requires an

Citation: Zatir S, Medjamea A, Bouazzaoui A, Lounici S, Bouchakor

S, Kroumli B, et al. Laparoscopic Cholecystectomy on Complete Situs
Inversus: About a Case, how does it Work? Surg Clin J. 2020; 2(2):
1022.
Copyright: © 2020 Zatir S
Publisher Name: Medtext Publications LLC
Manuscript compiled: Jun 24th, 2020
*Corresponding author: Zatir S, Department of General Surgery,
University Military Hospital of Oran, Algeria, E-mail: s.zatir@yahoo.com Figure 2: Intraoperative image.

© 2020 - Medtext Publications. All Rights Reserved. 028 2020 | Volume 2 | Article 1022
 Surgery Clinics Journal

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Figure 3: Position of the trocars.

© 2020 - Medtext Publications. All Rights Reserved. 029 2020 | Volume 2 | Article 1022